Connecting the dots: renin-angiotensin-aldosterone system, vitamin D, and hypertension.

Both hyperaldosteronism and vitamin D deficiency are associated with increased cardiovascular morbidity and mortality. Evidence from animal studies highlights the regulatory role of vitamin D in the renin-angiotensin-aldosterone system (RAAS) and its implications for blood pressure control. However, human studies have yielded conflicting results. This narrative review presents a conceptual framework linking vitamin D deficiency to RAAS dysregulation in hypertension, emphasizing systemic and local regulatory mechanisms. We discuss the effects of vitamin D on renin suppression, aldosterone modulation, and parathyroid hormone interactions, as well as confounding factors contributing to variability in findings. Finally, we outline research priorities, including thresholds for vitamin D deficiency, genetic influences, and interventional strategies, to better understand this critical axis.